三维重建模拟经皮拉力螺钉固定髋臼前柱骨折的解剖学研究

doi:10.13418/j.issn.1001-165x.2015

中国临床解剖学杂志 ›› 2015, Vol. 33 ›› Issue (2): 148-154.doi: 10.13418/j.issn.1001-165x.2015

三维重建模拟经皮拉力螺钉固定髋臼前柱骨折的解剖学研究

周华，高仕长，周程鹏，史黎晗

重庆医科大学附属第一医院骨科，重庆 400016

收稿日期:2014-04-02 出版日期:2015-03-25 发布日期:2015-04-21
通讯作者: 高仕长，副教授，副主任医师，硕士生导师，Tel：13594057589，E-mail：778925053@qq.com E-mail:654124203@qq.com
作者简介:周华（1986-），男，贵州贵阳人，在读硕士，主要从事骨科临床解剖学方面的研究，Tel：18883147549
基金资助:
重庆市科委（cstc2012gg-yyjs0205）; 重庆市渝中区科委（20110311）

The anatomic study of percutaneous lag screw fixation for anterior column fracture in acetabulum in virtual three-dimensional reconstruction model

ZHOU Hua, GAO Shi-chang, ZHOU Cheng-peng, SHI Li-han

Department of Orthopedics, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016，China

Received:2014-04-02 Online:2015-03-25 Published:2015-04-21

摘要/Abstract

摘要：

目的　测量髋臼前柱的解剖参数，评估术前拉力螺钉固定髋臼前柱的风险。方法收集155例成人骨盆CT扫描数据，其中男91例，女64例，重建骨盆三维模型。应用MIMICS软件在髋臼前柱置入虚拟螺钉，测量虚拟螺钉的最大直径、长度、进钉点，并计算虚拟螺钉方向。垂直髋臼前表面虚拟截骨，测量每个截骨面的内外径、上下径。计算髋臼前柱在真骨盆缘MN段的弧度。结果髋臼前柱允许置入虚拟螺钉的最大直径和长度在男性为（7.95±0.98）mm和（124.84±6.79）mm，女性为（6.42±1.15）mm和（120.00±7.52）mm；虚拟螺钉与水平面和矢状面的夹角在男性为（21.55±2.67）°、（42.15±2.54）°，女性为（21.85±5.10）°、（41.51±5.23）°；前柱MN段的弧度在男性为（38.29±3.28）°，女性为（43.41±3.50）°。以上数据除进钉方向外男女间均有显著差异。螺钉直径与性别、前柱弧度线性相关,相关系数分别为-0.468、 -0.164。女性髋臼前柱置入直径为6.50 mm、7.00 mm螺钉的风险分别是男性的9.081倍、13.316倍。结论对于中国人，建议使用直径为6.50 mm的拉力螺钉固定髋臼前柱骨折，当女性髋臼前柱弧度大于（44.49±2.47）°时，宜行钢板内固定。

关键词: 髋臼前柱, , 拉力螺钉固定, 应用解剖, 三维重建

Abstract:

Objective To assess the risk of lag screw fixation for anterior column by measuring the applied anatomy parameters of the acetabular anterior column. Methods CT scan data of 155 (91 males and 64 females) cases of adult pelvis were obtained and virtual three-dimensional model were reconstructed by software MIMICS. Virtual screws were placed in the anterior column of the acetabulum，then the maximum diameter, length, entrance point of the screws were measured and the direction of the screws were calculated. The virtual cuts was made perpendicular to anterior surface of acetabulum , then the inner-outer and vertical diameter of anterior column was measured respectively. The arc of the anterior column of acetabulum in the edge of true pelvic was calculated. Results In the men, the maximum diameter and length of virtual screws were (7.95±0.98) mm and (124.84±6.79) mm, In the women, the values were (6.42±1.15) mm and (120.00±7.52) mm. In the men, The angles between screws and horizontal plane (the screw pointed caput), sagittal plane(the screw pointed outside) were (21.55±2.67)° and (42.15±2.54)°; In the women, the values were (21.85±5.10)° and (41.51±5.23)°. In the men, The arc of the segment MN of anterior column was (38.29±3.28)°, which was (43.41±3.50)° in the women. All data presented statistical significance between men and women except the direction of virtual screws. There was linear correlation between screws diameter and gender, the arc of the anterior column, and the correlation coefficients were -0.468 and -0.164, respectively. The risks of the female received anterior column fixation by screws6.5mm and 7.0mm in length were 9.081 and 13.316 times greater than the male, respectively. Conclusions The lag screw of 6.5 mm in diameter is strongly recommended for fixating the anterior column fracture of the acetabulum in Chinese people. For female, when the arc of the acetabular anterior column is more than (44.49±2.47)°, plate fixation should be considered.

Key words: Acetabular anterior column, Lag screw fixation, Applied anatomy, Three-dimensional reconstruction

中图分类号:

R683.3

周华, 高仕长, 周程鹏, 史黎晗. 三维重建模拟经皮拉力螺钉固定髋臼前柱骨折的解剖学研究[J]. 中国临床解剖学杂志, 2015, 33(2): 148-154.

ZHOU Hua, GAO Shi-Chang, ZHOU Cheng-Feng, SHI Li-Han. The anatomic study of percutaneous lag screw fixation for anterior column fracture in acetabulum in virtual three-dimensional reconstruction model[J]. Chinese Journal Of Clinical Anatomy, 2015, 33(2): 148-154.

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三维重建模拟经皮拉力螺钉固定髋臼前柱骨折的解剖学研究

The anatomic study of percutaneous lag screw fixation for anterior column fracture in acetabulum in virtual three-dimensional reconstruction model

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